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High-density collagen patch prevents stricture after endoscopic circumferential submucosal dissection of the esophagus: a porcine model - 20/04/17

Doi : 10.1016/j.gie.2016.10.012 
Shigehisa Aoki, MD, PhD 1, ∗⁎, Yasuhisa Sakata, MD, PhD 2, ∗, Ryo Shimoda, MD, PhD 2, Toshiaki Takezawa, PhD 3, ⁎, Ayumi Oshikata-Miyazaki, PhD 3, Hiromi Kimura, MD 1, Mihoko Yamamoto, MD, PhD 1, Ryuichi Iwakiri, MD, PhD 2, Kazuma Fujimoto, MD, PhD 2, Shuji Toda, MD, PhD 1
1 Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan 
2 Department of Internal Medicine & Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, Saga, Japan 
3 Division of Biotechnology, Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, Ibaraki, Japan 

∗Reprint requests: Shigehisa Aoki (for esophageal research), MD, PhD, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.Department of Pathology and MicrobiologyFaculty of MedicineSaga University5-1-1 NabeshimaSaga 849-8501Japan∗∗Toshiaki Takezawa (for vitrigel research), PhD, Division of Biotechnology, Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, 1-2 Ohwashi, Tsukuba, Ibaraki 305-8634, Japan.Division of BiotechnologyInstitute of Agrobiological SciencesNational Agriculture and Food Research Organization1-2 OhwashiTsukuba, Ibaraki 305-8634Japan

Abstract

Background and Aims

Extensive excision of the esophageal mucosa by endoscopic submucosal dissection (ESD) frequently evokes a luminal stricture. This study aimed to determine the efficacy of a high-density collagen patch for the prevention of esophageal stricture in extensive ESD.

Methods

Six pigs underwent circumferential esophageal ESD under general anesthesia. In 3 pigs, artificial ulcers were covered by 2 collagen patches. The other 3 pigs underwent circumferential ESD only.

Results

The 2 collagen patches were settled onto the ulcer surface using a general endoscope and instruments. The collagen patch-treated group showed significantly better patency rates on both the oral and anal sides of the wound area compared with the control group at day 14. The mucosal re-epithelization ratio was significantly promoted, and the extent of mucosal inflammation and fibrosis was significantly decreased with the collagen patch treatment in the wound area. The frequency of cells positive α-smooth muscle actin was significantly reduced in the collagen patch-treated group compared with the control group.

Conclusions

We have established a high-density collagen device that can reduce the esophageal stricture associated with extensive ESD. This easy-to-handle device would be useful during superficial esophageal cancer treatment by ESD.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : αSMA, CVP, CTGF, ESD, HE, MD, ND, PSR


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 DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.


© 2017  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 85 - N° 5

P. 1076-1085 - maggio 2017 Ritorno al numero
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